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目的探讨剖宫产术后再次妊娠分娩的最佳方式。方法对2006年8月-2008年8月我院417例剖宫产术后再次妊娠孕妇的分娩方式、分娩结局及母婴并发症进行回顾性分析。结果417例中113例选择阴道试产,57例自然分娩,产程中因宫缩乏力给催产素2.5u+5%GS 250ml催产50例,中转手术17例,阴道试产成功96例,成功率为84.96%,无一例母婴不良妊娠结局发生;304例选择再次剖宫产,其中2例因胎盘附着在疤痕处、胎盘粘连、植入引起术中大量出血行子宫切除,术后恢复良好。结论疤痕子宫再次妊娠分娩并非剖宫产绝对指征,符合试产条件者,在严密的监护下阴道试产是安全可行的。
Objective To explore the best way to re-deliver pregnancy after cesarean section. Methods A retrospective analysis was made on the mode of delivery, delivery outcomes and maternal and infant complications in 417 pregnant women after cesarean section in our hospital from August 2006 to August 2008. Results In 417 cases, 113 cases were selected vaginal trial and 57 cases were given natural delivery. 50 cases were induced oxytocin 2.5u + 5% GS 250ml due to uterine inertia in the labor course, 17 cases were transferred and vaginal trial was successful. The success rate 84.96%, no case of maternal and child adverse pregnancy outcomes; 304 cases choose to cesarean section again, of which 2 cases of placenta attached to the scar, placenta accreta, intramedical bleeding caused by a large number of hysterectomy, postoperative recovery was good. Conclusion Reproductive pregnancy is not an absolute indication of cesarean section in scar pregnancy. It is safe and feasible for vaginal trial production under strict supervision.